Article

Births: Final data for 1998

Authors:
  • National Center for Healh Statistics/Centersfor Disease Control and Prevention
To read the full-text of this research, you can request a copy directly from the authors.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Induction of labor (IOL) is needed in certain condition and in the recent times, the rate of induction is increasing and according to a survey this prevalence is seen in 20% of the cases. 1 Induction of labor is needed when there is a risk to either fetus or the mother in case of continuing with spontaneous method. It is observed by the ripening of the cervix which has a linear association with spontaneous induction or augmentation required. ...
Article
Full-text available
Objective: Comparison between intra cervical catheter vs Misoprostol for successful induction of labor. Study Design: Randomised-controlled trial Settings: Department of Gynecology and obstetrics, Allama Iqbal Memorial Teaching Hospital, Sialkot. Duration: July to December 2018. Methodology: The cases were chosen between the age of 20 to 40 years with gestation age of more than 37 weeks at presentation. The cases with Bishop score, equal or less than 4 were divided into two equal groups where the cases in group A were managed by intra vaginal Misoprostol (25 micro-gram tablet, every 4 hours for a maximum of 6 doses) and those in group B with intra cervical Foleys catheter and were assessed for outcomes like time for induction of delivery and uterine status. Results: In this study there were total 100 cases, 50 in each group. The mean age of the participants in group A and B was 28.17±5.37and 29.13± 7.03 years (p=0.88). Mean gestation age at presentation was 38.78±1.3 vs 38.14±1.1 weeks with p= 0.95. There were 38% cases in group A and 44% in B that were primi gravida. Most common cause for labor induction was pre-eclampsia seen in 20% case each with p= 1.0 as shown in table I. Latent phase in group A and B was 8.4±4.9 vs 10.1±6.7 (p= 0.21) and mean time to delivery was 10.67±5.1 vs 13.9±9.67 hours with p= 0.01. Conclusion: Misoprostol is better than intra cervical catheter regarding mean time of delivery.
... This resulted in a study population of 96. [7,8] These were distributed by lottery method into Groups 0; having been given SL Misoprostol alone and Group 1; given the same in addition to cervical placed Foley's catheter. After randomization using random numbers generator, each group had 48 patients. ...
Article
Full-text available
Background: Labour is traditionally induced with sub lingual (SL) misoprostol but researchers have proposed greater effectives and benefits if Foley's catheter is also used. Aims and Objectives: The aim was to study the effect of cervical Foley's catheter and misoprostol on labour induction in comparison to SL misoprostol alone. Materials and Methods: This randomised controlled trial was conducted from January 2020 to January 2021 on a study population of 96 female patients. They were distributed by lottery method into Groups 0; having been given SL misoprostol alone and Group 1; given the same in addition to cervical Foley's catheter. After randomisation, each group of 48 patients was noted for the method of delivery and time from induction to delivery in hours. Results: Groups 0 and 1 had 48 patients each with a total of 96 patients. Overall means for age in years and age of gestation in weeks were 25.80 ± 5.73 and 39.51 ± 1.13, respectively. Overall parity was 1.88 ± 0.83. Normal vaginal delivery (NVD) was seen in 25 (26%) patients in Group 0 and 34 (35.4%) in Group 1, P = 0.01. Meantime from induction to delivery for Group 0 was 17.89 ± 1.05 h and for Group 1 13.93 ± 1.47 h respectively, with a difference of 3.96 ± 0.42 h and P = 0.01. Conclusion: The combination of misoprostol and Foley's catheter in the cervix is associated with more vaginal deliveries characterised by shorter times of delivery.
... To determine whether this over-representation might be observed in other regions, we obtained data from two other states, Arkansas and Missouri ( Figure 6). Although the number of observations is too small (<20) in some groups to reliably estimate the confidence intervals (Ventura et al., 2000), the Hispanic group had the greatest incidence of newborns with transiently elevated C3 in all three states. ...
Article
The biological and clinical significance of the p.E88del variant in the transcobalamin receptor, CD320, is unknown. This allele is annotated in ClinVar as likely benign, pathogenic, and of uncertain significance. To determine functional consequence and clinical relevance of this allele, we employed cell culture and genetic association studies. Fibroblasts from 16 CD320 p.E88del homozygotes exhibited reduced binding and uptake of cobalamin. Complete ascertainment of newborns with transiently elevated C3 (propionylcarnitine) in New York State demonstrated that homozygosity for CD320 p.E88del was over‐represented (7/348, p < 6 × 10−5). Using population data, we estimate that ~85% of the p.E88del homozygotes born in the same period did not have elevated C3, suggesting that cobalamin metabolism in the majority of these infants with this genotype is unaffected. Clinical follow‐up of 4/9 homozygous individuals uncovered neuropsychological findings, mostly in speech and language development. None of these nine individuals exhibited perturbation of cobalamin metabolism beyond the newborn stage even during periods of acute illness. Newborns homozygous for this allele in the absence of other factors are at low risk of requiring clinical intervention, although more studies are required to clarify the natural history of various CD320 variants across patient populations.
... Preeclamsia (PE) is a multisystem disorder of unknown etilogy characterized by development of hypertension (HTN) with proteinuria after the 20 th weeks of pregnancy in a previously normotensive and non proteinuric women. 1 It is the leading cause of maternal and perinatal morbidity and mortality. 2 About 3-5% of the pregnancies in general are complicated with this syndrome 3 and about 18% of pregnant women die of this problem. 4 Other major ...
Article
Background & objective: To see the relationship between preeclampsia and iron parameters (serum iron, serum ferritin and total iron binding capacity). Methods: The present case-control study was carried out in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka in collaboration with the Department of Biochemistry, BSMMU, Dhaka over a period of 1 year from July 2012 to June 2013 Pregnant women with preeclampsia admitted in the above-mentioned hospital were considered as case, while the pregnant women without preeclampsia were included as control. A total of 60 women-31 cases and 29 controls were purposively included in the study. The exposure variables were serum ferritin, serum iron and total iron binding capacity (TIBC), while the outcome variable was preeclampsia. The serum iron level > 100 μg/L was considered as hyperferritenemia. Result: Nearly two-thirds of the women were in their 2nd decades of life belonged to lower socioeconomic class. The body mass index was also fairly comparable between the groups with most women having normal BMI. No significant difference was observed between the groups with respect to obstetric variables as well. Level of haemoglobin and hematocrit were also identically distributed between groups. The result showed that a significantly higher proportion (35.5%) preeclamptic women had elevated serum ferritin (> 100 μg/L) as opposed to 10.3% of the control group (p = 0.021). The risk of developing raised serum ferritin in women with preeclampsia was estimated to be 4-fold (95% CI =1.2 – 19.4) higher than that in the normal pregnant women. Analyses also revealed that women with severe preeclampsia had a higher mean serum ferritin (207.3 ± 44.1 ng/ml) than the women with mild preeclampsia (41.7 ± 2.7) and an even higher level compared with the normal pregnant women (21.7 ± 1.4 μg/ml) (p = 0.001). Similar result was observed in serum iron with greater the severity, higher is the level of serum iron (p = 0.067). Conversely, the serum total iron binding capacity (TIBC) was decreased with severity of preeclampsia (p = 0.058). Conclusion: The study concluded that women with preeclamsia might be associated with higher serum ferritin, higher serum iron and lower serum TIBC although it is not known whether the rise in serum ferritin and serum iron precedes or contributes to the clinical manifestations of preeclampsia. Ibrahim Card Med J 2017; 7 (1&2): 64-69
... These figures are higher compare to developed countries. In a study they stated, "the incidence of 1 in 3250 pregnancies in US [11] and 1 in 2000 pregnancy in Europe [12] were found. In developed countries, the incidence of eclampsia is significantly low probably because of the comprehensive antenatal care, early detection of pre eclampsia, and its management, and uniform national health care policy. ...
... [3][4][5][6][7][8][9][10] In the United States, the mean maternal age at the time of birth has risen to 28.8 years; for comparison, in 1998 it was 24.3 years and in 1972 was 22.0 years. 11,12 There is a large body of literature that has investigated the impact of AMA on maternal and fetal outcomes. Although reports have varied, 1,[13][14][15] AMA has been associated with adverse maternal and fetal outcomes and pregnancy complications, including increased risk for gestational diabetes, preeclampsia, placenta previa, macrosomia, preterm birth, stillbirth, and increased rates of cesarean delivery; very AMA (vAMA; age .40 or 45 at the time of delivery, depending on the study) has also been associated with higher risks of low birth weight, stillbirth, and perinatal death. ...
Article
Context.— The percentage of pregnant women with advanced maternal age (AMA) has increased during the past several decades due to various socioeconomic factors and advances in assisted reproduction. These pregnancies are associated with adverse maternal and fetal outcomes. However, the underlying placental pathology has not been well described. Objective.— To investigate the placental histopathology associated with AMA pregnancies. Design.— Placental pathology from 168 AMA women 35 years or older at delivery was reviewed. The cases were subdivided into two age subgroups, ages 35 to 39 and 40 or older, as well as a “pure AMA” subgroup where the only indication for placental examination was AMA. A group of 60 consecutive non-AMA placentas was also identified and used as comparison. The spectrum of histologic features in each case was catalogued. Results.— Of the overall AMA cases, meconium deposition was seen in 55% (93 of 168), chorangiosis in 40% (68 of 168), and acute chorioamnionitis in 36% (60 of 168). Fetal vascular malperfusion was also seen with high frequency (30%; 50 of 168). Two histologic alterations found to be significantly different between the 35 and 39 and greater than 40 age subgroups were fetal vascular malperfusion (11% [7 of 65] versus 42% [43 of 103]; P = .001) and delayed villous maturation (1.5% [1 of 65] versus 13% [13 of 103]; P = .02). The pure AMA subgroup showed no statistically significant differences compared with the overall AMA group. Chronic deciduitis was the only statistically significant difference between the overall AMA group and the non-AMA comparison group (14% [23 of 168] versus 30% [18 of 60]; P = .02). Conclusions.— Our findings, particularly the high frequency of fetal vascular malperfusion, suggest that AMA should be an independent indication for placental pathologic examination.
... In developed countries, the incidence of eclampsia ranges from 1 in 2000 to 3000 deliveries, whereas in developing countries, the rate is around 1 in 100 to 1 in 1700 births. [3][4][5][6] On neuroimaging in patients of eclampsia, the underlying central nervous system pathology showed subcortical edema involving the posterior lobes predominantly. This was first described in 1996 by Hinchey et al, as posterior reversible encephalopathy, a clinico-radiological syndrome which was marked by headache, altered mental status, seizures, visual disturbances, and extensive whitematter changes suggestive of posterior cerebral edema and was given the name reversible posterior leukoencephalopathy syndrome. ...
Article
Full-text available
Background: Posterior reversible encephalopathy is a clinico-radiological syndrome marked by headache, altered mental status, seizures, visual disturbances, and extensive white-matter changes, also known as hyper perfusion encephalopathy, brain capillary leak syndrome, and hypertensive encephalopathy. This syndrome was a possible consequence of several medical conditions but especially in pregnancy it is associated with pre-eclampsia and eclampsia. Objective of this study was to know the incidence and analyze the clinical features, biochemical, and radiological abnormalities in posterior reversible encephalopathy syndrome (PRES) as a complication of preeclampsia.Methods: This was a one-year cross-sectional analytical study conducted at NRI general hospital, Chinakakani, Guntur of patients with the diagnosis of PRES. Data was obtained from medical records and analyzed them in terms of mean for continuous variables and percentages for categorical data.Results: Total no of patients diagnosed as PRES were 16 out of 127 patients of preeclampsia. Among them, 14 presented with eclampsia, and two presented with severe preeclampsia and imminent symptoms of eclampsia. Headache was the most common symptom (100%). PRES occurred at a peak SBP of ≥160 mmHg in 75% cases and peak DBP of ≥110 mmHg in 50% cases. Serum lactate dehydrogenase (LDH) level was ≥600 in 56.25% and serum uric acid level ≥6 in 50% of patients of PRES. The drug of choice was magnesium sulfate.Conclusions: Neuroimaging abnormality is a definitive component in the diagnosis of PRES. These cerebral abnormalities are vital components in the pathogenesis of eclampsia. Considerable number of patients of preeclampsia might develop PRES even without eclampsia, with mild elevation in BP, serum LDH, and serum uric acid levels.
... [9] This was lower than the 10% observed in 1998. [10] In Wales, the prevalence dropped from 4.6% in 1990 to 2.8% in 1996. [11] The decline in the prevalence of prolonged pregnancy was associated with increasing rates of induction of labor. ...
... The incidence of eclampsia in the United States has been reported to be 1 in 3,250 births. 3 Administration of magnesium sulfate for seizure prophylaxis (in the absence of contraindications) has been the standard of care since the publication of the Magpie Trial in 2007. 4 A Canadian study found that the incidence of eclampsia declined dramatically from 12.4 per 10,000 deliveries in 2003 to 5.9 in 2009, likely due to increased use of magnesium sulfate for seizure prophylaxis. ...
Article
Full-text available
Introduction: Pre-eclampsia is a hypertensive disorder in pregnancy. Maternal sequelae that may occur include impaired liver function, disseminated intravascular coagulation, seizures (eclampsia), stroke, and death. Thus, providers should know how to recognize (diagnose) and treat pre-eclampsia and eclampsia. Methods: A simulator with noninvasive blood pressure monitoring was used. Transducers for fetal heart rate and contraction monitoring were placed on the simulator, which represented the patient. After obtaining a history and performing a physical examination, resident physician (postgraduate years 1-4) and nurse learners had to diagnose pre-eclampsia and treat this condition. They also had to treat severe-range blood pressures and manage eclampsia. Learner performance was assessed with a checklist. Debriefing followed the simulation. Results: Thirty resident learners participated in the study. Nurses did not participate. All resident learners indicated familiarity with the diagnosis and management of pre-eclampsia and emergent hypertension and managed these conditions correctly. All resident learners reported not being confident in managing eclampsia. None of the learners were able to stop the eclamptic seizure. All resident learners were more confident in managing eclampsia after the scenario compared with before (mean confidence level 3.6 ± 0.5 vs. 1.1 ± 0.4, p < .001). Discussion: Resident learners were familiar with the management of pre-eclampsia and emergent hypertension but not with eclampsia. We recommend that eclampsia simulations occur in a laboratory and in situ on the labor and delivery floor with interprofessional team members including obstetricians, nurses, anesthesiologists, emergency and family medicine physicians, nurse practitioners, and physician assistants.
... Approximately 15-25% of all pregnant women require oxytocin for either induction of labor [11,12]. Despite its extensive use, there is no consensus regarding the initial dose, dosage increments, and/or the maximal dose [13][14][15]. ...
... The incidence of multiple births has changed over time, presenting a decline until the late 1970s and an increase thereafter [9]. It is estimated that in the United States in 1980 there were 37 triplets or higher order births per 100,000 births, rising up to 1935 per 100,000 births in 1998 [10,11]. Quadruplet and quintuplet or higher births raised from 229 and 40 in 1989 to 627 and 79, respectively, in 1998. ...
... However, approximately 20% of women having induction of labor end up having a cesarean delivery. (1) Labor induction in unfavorable cervix often results in failed induction or prolonged labor with increased risk of operative delivery and morbidity. (2) Bishop established the relationship between cervical ripeness (i.e. ...
Article
Full-text available
Objectives: To compare the efficacy and safety of vaginal nitros oxide (NO) donors, isosorbide mononitrate (IMN), and intracervical Foley's catheter for cervical ripening and labor induction in singleton pregnancies. and a private center. Patients & Methods: One hundred twenty pregnant candidates for pre-induction cervical ripening were randomly divided into 2 equal groups, Group-I ;(n=60) induction of labor (IOL) was done with intracervical Foley's catheter, and Group-II ;(n=60, but 2 women refused to complete the study and their results were excluded), IOL was done with vaginal isosorbide mononitrate (IMN). Results: There was no significant difference between intracervical Foley's catheter and intravaginal IMN as regard their success in producing cervical ripening and labor induction {50/60 (83.3%) vs.45/58(77.6%); p>0.05}. In catheter group, there were significantly shorter induction delivery interval (19.7±7.2 hours vs. 24.3±7.0 hours; P <0.01), significantly greater number of women delivered within 24 hours of start of induction (90%%vs. 73.3%; <0.05), and significantly less need for oxytocin augmentation (70%vs. 93.3%; P <0.05) as compared to IMN group. No significant differences existed in rates of uterine tachysystole, caesarean section (CS), successful VBAC, maternal and neonatal morbidity. Conclusion: Transcervical Foley's catheter and vaginal IMN were considered effective and of comparable safety for pre-induction cervical ripening. Shorter induction delivery interval, increased number of deliveries within 24hours of induction, and less need for oxytocin augmentation were noted in catheter group. However, more studies with higher volume samples are needed to justify these results.
... Factori genetici Au fost descoperiţi ca implicaţi în patogeneza preeclampsiei polimorfismele genei angiotensinogenului (AGT) M235Tşi T174M, asociate cu o activitate crescută a sistemului renină-angiotensină aldosteron (RAAS) și genele implicate în diferite tipuri de trombofilie. Între factorii de risc semnificativ se numără: • vârsta > 40 ani sau <18 ani • istoric familial de preeclampsie • indicele de masă corporală mare • rasa neagră • partener masculin a cărui mamă a avut preeclampsie • gravidă cu creștere insuficientă în greutate pentru vârsta gestaţională • factori legaţi de partener (partener nou, expunerea limitată a spermei -de exemplu, utilizarea anterioară de barieră contraceptivă) • fumatul scade riscul de preeclampsie • hipertensiune cronică • boală renală cronică • sindrom antifosfolipidic sau trombofilie moștenită • boli vasculare sau boli ale ţesutului conjunctiv • diabetul zaharat • sarcina multiplă • hydrops fetalis • restricţie de creștere intrauterină neexplicată • restricţie de creștere fetală, abruptio placentae sau deces fetal într-o sarcină anterioara • interval intergestaţional prelungit • molă hidatiformă • gene de susceptibilitate • boală renală cronică (IRC) (17,18,19) Diagnosticul preeclampsiei Criterii de diagnostic: TA sistolică ≥140 mmHg sau TA diastolică ≥90 mmHg, proteinurie ≥ 0,3g într-o probă de 24 de ore de urină sau raport proteine / creatinină ≥0.3 sau semne de disfuncţie a organelor ţintă (număr de trombocite sub 100000/mm3, creatininei serice >1,1 mg/dl sau dublarea creatininei serice, sau transaminazelor serice crescute până la de două ori valorile normale. Clasificare preeclampsiei: 1. După momentul apariţiei: • preeclampsie cu debut precoce înaninte de 34 săptămâni gestaţionale • preeclampsie cu debut tardiv după 34 săptămâni gestaţionale 2. După prognosticul materno-fetal • Preeclampsie cu evoluţie severă • Preeclampsia fără evoluţie severă 3. După starea fătului si funcţia placentară • hipoperfuzia cronica placentar • oligohidramnios restrictie de crestere fetale 4. După aspectul Doppler la nivelul arterelor uterine Modificările morfologice și funcţionale ale arterelor spiralate determină un aspect particular al examenului Doppler la nivelul arterelor uterine cu creșterea vitezei de circulaţie la nivelul acestora care se reflectă în creșterea indicelui de pulsatilitate (IP) și apariţia incizurii protodiastolice; persistenţa incizurii protodiastolice dup 22-23 de săptămâni gestaţionale și caracterul bilateral al modificărilor de flux uterin sunt sugestive pentru evoluţia sarcinii spre preeclampsie. ...
... thousand compared to 12.1 for non-Latino whites. 63,64 The high birth rates are related to the younger population profile of the Latino population as well as their relatively large families. Mexican American women have a particularly high fertility rate; those from 20 to 24 years of age in 1998 had 197.6 births per thousand, compared with 90.7 for white women. ...
... However, others have used 4500 g as the cutoff point [1]. Approximately, 10% of all newborns have a birth weight C4000 g, and 1.5% weight [4500 g [8]. There are no nationally or internationally agreed established weight limits for macrosomia; the American College of Obstetricians and Gynecologists recommends 4500 g because of the marked increase in maternal and neonatal complication rates at this weight [9]. ...
Article
Full-text available
Objectives: To explore the predictive power of measuring the abdominal fetal fat layer (FFL) as a soft tissue marker at 31, 34, and 37 weeks' gestation to improve the detection of fetal macrosomia in pregnant women with GDM, in addition to the biometric values with close monitoring of maternal blood sugar level and BMI changes. Methods: We conducted a prospective observational study at the Department of Obstetrics, University Hospitals, Campus Kiel, Germany, in collaboration with diabetic clinic staff. Participants underwent a third-trimester scan and extra FFL measurements were performed at 31, 34, and 37 weeks of gestation. The clinical outcomes of pregnancy and birth weight were collected from the obstetric record. All of the enrolled women had an early pregnancy ultrasound scan to confirm gestational age. Results: The FFL at 34 and 37 weeks, with respective cutoff values of >0.48 cm and >0.59 cm, showed a very good sensitivity of 60% for both gestational points, and specificity of 89.3 and 90.6%, respectively. The probability of fetal macrosomia could be more than doubled if the FFL at 34 weeks was more than 0.48 cm. However, the probability of macrosomia dropped to 16% if the FFL was ≤0.48 cm. The median FFLs of macrosomic fetuses at 34 and 37 weeks were 0.50 (IQR 0.10) and 0.60 (IQR 0.25) cm, respectively. The mean age of the study population (n = 80) was 32.26 (SD = 5.06) years. In our study population, ten newborns were born with birth weight >4000 g. The body mass index (BMI) for the mothers of later-onset macrosomic newborns showed higher median values of 30 (IQR 8), 32 (IQR 5), and 33 (IQR 9) at 31, 34, and 37 weeks, respectively, in comparison to mothers of non-macrosomic newborn. However, the BMI did not show any statistically significant difference from those with normal-weight newborn and did not show any specific sensitivity for predicting macrosomia. Conclusion: Measuring the FFL at 34 and 37 weeks of gestation, in addition to the standard measurement, might be useful for predicting macrosomia and is worth further evaluation.
... The decline in higher-order multiple births over the last decade and a half cannot be attributed to changes in the maternal age distribution (older women are more likely to have a multiple birth and are more likely to seek fertility-enhancing services). That is, the trend toward older age at childbearing has continued throughout the study period with the percentage of births to women aged 30 and over rising from 36% in 1998 to 44% in 2014 (2,3). Changes in assisted reproductive technologies (ART) practices, such as reducing the number of embryos transferred in ART procedures, have been associated with the decline in higher-order multiple births (7,8). ...
Article
Key findings: Data from the National Vital Statistics System •The triplet and higher-order birth rate declined 41% from 1998 to 2014, or from about 1 in every 515 births in 1998 to one in every 880 births in 2014. •Triplet and higher-order birth rates were down by about 50% or more for women aged 25 and over. Rates were essentially unchanged for women under 25. •The largest declines in triplet and higher-order birth rates by race and Hispanic origin for 1998-2014 were for non-Hispanic white women, down 46% compared with a 15% decline for Hispanic women, and essentially no change for non-Hispanic black women. •Triplet and higher-order birth rates were down from 1998-2000 to 2012-2014 in 42 states; declines of more than 50% were observed in 7 states.
... 105) In contrast, the rate of macrosomia in the United States was 10%. 106) Thus, birth weight varies greatly by region and historical transition. Furthermore, because of the considerable contribution of genetic background and other factors, such as preterm deliveries, multiple pregnancies, maternal complications, fetal complications, and placental deficiencies, small and large babies are not always solely the result of undernourishment and overnourishment in utero, respectively. ...
Article
Non-communicable diseases (NCDs) are chronic diseases that are non-infectious and non-transmissible. The World Health Organization (WHO) classifies cardiovascular disorders (myocardial infarction or stroke), diabetes, chronic respiratory diseases, and malignancy as the four major disease types of NCDs. Evidence supporting the influence of various environmental factors in the early developmental period on the risk of developing NCDs in adults has increased recently, leading to the proposal of the developmental origins of health and disease (DOHaD) theory. We reviewed the background of the paradoxical circumstances in which the morbidity of NCDs has rapidly increased in both developing and developed countries in view of distinct prenatal nutritional environments in the context of the DOHaD theory. We also discuss candidates for early interventions and biological samples for identifying biological markers in individuals at high risk of NCDs from the perspective of preemptive medicine in perinatal care.
... Incidence of eclampsia is 1 in 2000 to 3250 [1,2], deliveries in developed countries and 1 to 5% in India [3,4]. Eclamptic seizures can occur antepartum, intrapartum or postpartum. ...
Article
Full-text available
Objectives: Incidence of eclampsia is 1 in 2000 to 3250 deliveries in developed countries and 1 to 5% in India. Posterior reversible encephalopathy syndrome (PRES) is a constellation of symptoms caused by reversible ischaemia mostly of the posterior cerebral vasculature. PRES has been associated with preeclampsiaeclampsia and acute renal injury. We present a study of patients in whom eclampsia was complicated with PRES. Our aim was to study the clinico-radiological profile, associated complications and outcome of patients who had eclampsia with PRES. Materials and Methods: A retrospective study was done of all pregnancies diagnosed as eclampsia with PRES syndrome over a four year period from August 2010 to July 2014 managed at Karnataka institute of medical sciences, Hubli, India. Results: Eleven patients had eclampsia with PRES syndrome of the 36,094 patients delivered in the institution over the study period. Nine of these were primigravidas, 8 were of 20-25 years age group, 10 presented with multiple seizure episodes. In eight patients seizures were controlled only with MgSo4 . Perinatal mortality was seen in three patients. There were no maternal deaths in these cases. Conclusion: Incidence of eclampsia with PRES syndrome was 0.03% amongst the patients delivered in Karnataka institute of medical sciences. The incidence of PRES was more amongst cases of postpartum eclampsias as compared to antepartum eclampsias. PRES was more common in primigravidas and younger age group (20 to 25 years). Signs of imminent eclampsia like headache, epigastric pain and blurring vision were uncommon in these patients. In the majority of the patients seizures were controlled with MgSo4 alone. Prognosis of eclamptic patients with PRES was favourable.
Article
In1998, the Boston Birth Cohort (BBC) was initiated at Boston Medical Center (BMC) in response to persistently high rates of preterm birth (PTB, defined as birth before 37 weeks of gestation) in the US population and the longstanding profound PTB disparity among Black, Indigenous, and people of color (BIPOC). The BBC encompasses two linked study protocols: The PTB Study serves as the baseline recruitment in the BBC. It aims to address fundamental questions about the causes and consequences of PTB. The study oversamples preterm babies using a case/control study design, in which cases are defined as mothers who deliver a preterm and/or low birthweight baby (<2500 grams regardless of gestational age). Controls are enrolled at a 2:1 control/case ratio and matched by maternal age (±5 years), self-reported race and ethnicity, and date of delivery (± 7 days for case delivery). From inception, it was designed as a comprehensive gene-environmental study of PTB. As a natural extension, the Children’s Health Study, under a separate but linked Institutional Review Board protocol, is a longitudinal follow-up study of the participants who were recruited at birth in the PTB Study and who continue pediatric care at BMC. This linked model allows for investigation of early life origins of pediatric and chronic disease in a prospective cohort design. The BBC is one of the largest and longest National Institutes of Health–funded prospective birth cohort studies in the United States, consisting of 8733 mother-child dyads enrolled in the PTB Study at birth, and of those, 3592 children have been enrolled in the Children’s Health Study, with a median follow-up of 14.5 years. The BBC mirrors the urban, underresourced, and underrepresented BIPOC population served by BMC. A high proportion of BBC children were born prematurely and had chronic health conditions (e.g., asthma, obesity, and elevated blood pressure) in childhood. The BBC’s long-term goal has been to build a large, comprehensive database (epidemiological, clinical, and multiomics) and biospecimen repository to elucidate early life origins of pediatric and chronic diseases and identify modifiable upstream factors (e.g., psychosocial, environmental, and nutritional) to improve health across the life course for BIPOC mothers and children.
Article
Full-text available
This study aimed to determine the relationship between estimated fetal weight discordance by ultrasonography and maternal and neonatal outcomes in dichorionic diamniotic twin pregnancies. We conducted a retrospective review of the medical records of 106 twin pregnancies delivered at a single tertiary center between January 2011 and February 2020. At 20–24 and 28–32 weeks of gestation, participants were divided into two groups: discordant twins with an estimated fetal weight difference of more than 20% and concordant twins with a weight difference of less than 20%. Maternal complications and neonatal outcomes were compared between the two groups. Although the incidences of preeclampsia and placenta previa were significantly higher in discordant twins measured between 20 and 24 weeks, no statistical significance was found in neonatal outcomes. Delivery times were earlier, and neonatal weights were lower in discordant twins measured between 28 and 32 weeks. Neonatal outcomes such as ventilator use and neurodevelopment were also significantly different. Discordance in estimated fetal weight measured using ultrasonography between 20 and 24 weeks can be a risk factor for maternal preeclampsia and placenta previa, whereas discordance at 28–32 weeks may predict poor neonatal outcomes.
Article
Анализируется динамика близнецовой рождаемости в России за период 1959–2008 гг. Население мира в целом и России в частности рассматривается как самоорганизующаяся демографическая система, динамические изменения которой носят нелинейный характер. Показано, что общемировые тенденции накладываются на локальные российские процессы, определяющие динамику рождаемости в отдельной стране как части глобальной системы народонаселения.
Article
Kernicterus Spectrum Disorders (KSDs) result from hyperbilirubinemia-induced brain injury. We developed a Toolkit (KSD-TK) to predict the likelihood of KSDs. This study aims to validate the KSD-TK by comparing it to clinical diagnoses made by the Kernicterus Clinic in the Division of Neurology. Through retrospective chart review, we completed a KSD-TK for 37 patients evaluated between 2011 and 2019 using highest bilirubin, newborn risk factors, neonatal exam, follow-up exam, auditory testing, tooth enamel, and MRI brain results. KSD-TK results were compared to the clinical diagnoses given by a kernicterus expert (SS). Of 37 patients, 29 were clinically diagnosed with kernicterus, including 14/14 with KSD-TK scored as “definite”, 14/15 “probable”, and 1/2 with “possible” kernicterus. None of 6 patients with KSD-TK “not kernicterus” were clinically diagnosed with kernicterus. Combining KSD-TK “definite” and “probable”, the KSD-TK has 96.6% sensitivity and 87.5% specificity. Each KSD-TK component had high sensitivity, but only three had specificity ≥0.75: auditory neuropathy spectrum disorder, abnormal movements and/or tone on follow-up exam, and abnormal globus pallidus and/or subthalamic nucleus on MRI. The KSD-TK is a promising screening tool for patients at risk for kernicterus. This study provides validation of a Kernicterus Spectrum Disorders (KSDs) Toolkit. The toolkit provides screening criteria for predicting KSD diagnosis. Scores of definite or probable have high sensitivity and specificity for KSDs. Abnormal auditory processing, exam, and MRI were most specific for KSDs.
Thesis
This manuscript has been reproduced from the m icrofilm master. UMI film s the te x t directly from the original o r copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type o f computer printer. The q u a lity o f th is re p ro d u ctio n is dependent u p o n th e q u a lity o f th e co p y s u b m itte d. Broken o r indistinct print, colored o r poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignm ent can adversely affect reproduction. In th e unlikely event th at the author did not send UMI a complete manuscript and there are missing pages, these w ill be noted. Also, if unauthorized copyright material had to be removed, a note w ill indicate the deletion. Oversize m aterials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning a t the upper left-hand com er and continuing from le ft to right in equal sections with small overlaps.
Article
Objective The purpose of this study was to compare prenatal characteristics and postpartum outcomes among Somali and non-Somali women residing in Olmsted County.Methods We reviewed the medical records for a cohort of Somali women (≥18 years old; N= 298) who had singleton births between January 2009 and December 2014 and for an age-matched non-Somali cohort (N= 298) of women residing in Olmsted County, Minnesota. Logistic regression models which accounted for repeated measures were used to assess differences in prenatal and postpartum outcomes between Somali and non-Somali women.ResultsSomali women had a significantly higher odds of cesarean section (adjusted OR=1.81; 95% CI=1.15, 2.84). Additionally, Somali women had a significantly lower odds of postpartum depression (adjusted OR=0.27; 95% CI=0.12, 0.63).Conclusion The reported adverse postpartum outcomes have implications for interventions aimed at addressing perinatal care disparity gaps for Somali women immigrant and refugee populations.
Article
Full-text available
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.
Chapter
Post‐term pregnancy is one that progresses to 42 weeks’ gestation. Key in making the proper diagnosis of post‐term pregnancy is accurate pregnancy dating, best done with confirmational first‐trimester ultrasound. The epidemiology is the opposite to preterm birth, with higher rates in obese women and those of white race/ethnicity. Such prolonged pregnancy is also seen more commonly with fetal complications such as anencephaly and placental sulfatase deficiency, pointing towards a fetal contribution to the initiation of labour. Complications of post‐term pregnancy include higher rates of stillbirth, caesarean delivery, meconium‐stained amniotic fluid, neonatal acidaemia and neonatal death. One advantage of post‐term pregnancy is that it is easily preventable with induction of labour. However, the timing of such induction during the term period is costly and understudied.
Article
Full-text available
Immigrant women face unique barriers to prenatal care access and patient-provider communication. Yet, few prior studies have examined U.S.-born/immigrant differences in the content of care. The purpose of this study was to investigate the roles of immigrant status, English proficiency and race/ethnicity on the receipt of self-reported prenatal counseling using nationally representative data. We used data from the Early Childhood Longitudinal Study-Birth Cohort (N ≈ 8100). We investigated differences in self-reported prenatal counseling by immigrant status, English proficiency, and race/ethnicity using logistic regression. Counseling topics included diet, smoking, drinking, medication use, breastfeeding, baby development and early labor. In additional analyses, we separately examined these relationships among Hispanic, Mexican and Non-Hispanic (NH) Asian women. Neither immigrant status nor self-reported English proficiency was associated with prenatal counseling. However, we found that being interviewed in a language other than English language by ECLS-B surveyors was positively associated with counseling on smoking (OR, 2.599; 95% CI, 1.229–5.495) and fetal development (OR, 2.408; 95% CI, 1.052–5.507) among Asian women. Race/ethnicity was positively associated with counseling, particularly among NH black and Hispanic women. There is little evidence of systematic overall differences in self-reported prenatal counseling between U.S.-born and immigrant mothers. Future research should investigate disparities in pregnancy-related knowledge among racial/ethnic subgroups.
Article
Full-text available
Trends in birthweight and abnormal fetal growth, namely term low birthweight (LBW), macrosomia, small-for-gestational age (SGA) and large-for-gestational age (LGA), are important indicators of changes in the health of populations. We performed this epidemiological study to evaluate these trends among 2,039,415 singleton live births from Israel over a period of 15 years. Birth certificate data was obtained from the Ministry of Health. Multivariable linear and logistic regression models were used to evaluate crude and adjusted estimates compared to the baseline of 2000 and polynomial trends. During the study period we observed a significant decrease in the rates of infants born SGA and LGA (10.7% to 9.2%, 10.2% to 9.6% respectively). After adjustment, based on the imputed data set, term mean birthweight increased by 6.0 grams (95% CI: 2.9, 9.1), and term LBW odds decreased by 19% in 2014 compared to 2000 (adj ORs: 0.81; 95% CI: 0.77, 0.85). Significant decreases were also observed for adjusted SGA, LGA and macrosomia rates. The decrease in abnormal fetal growth rates were not entirely explained by changes in sociodemographic characteristics or gestational age and may imply real improvement in child intrauterine growth in Israel during the last 15 years, especially in the Jewish population.
Article
Full-text available
Das Kardiotokogramm (CTG), in den 1960er-Jahren eingeführt, ist heute die geburtshilfliche Maßnahme, die unter der Geburt am häufigsten angewendet wird. Die Vorstellung, das Wohlbefinden des Feten nichtinvasiv unter der Geburt zu kontrollieren bzw. eine drohende Asphyxie rechtzeitig zu erkennen, ist genial, ließ sich allerdings nicht in randomisierten Studien bestätigen. Die Sensitivität des CTG ist mit 99 % sehr hoch, die Spezifität mit 77 % gering. Die hohe Rate an falsch-positiven Befunden führte vor allem zu einer Steigerung der Sectiorate, ohne die Rate an Zerebralparesen signifikant zu reduzieren. Gründe dafür sind die große Interobserver-Variabilität und die Heterogenität der einzelnen Risikokollektive. Mit den neuen FIGO(International Federation of Gynecology and Obstetrics)-Leitlinien werden sowohl die Begriffe einheitlich definiert als auch direkte Handlungsempfehlungen gegeben. Zusätzliche Maßnahmen, wie Mikroblutuntersuchung oder eine Kopfstimulation, können weitere Informationen über die fetale Reserve unter der Geburt liefern.
Article
Buscou-se, por meio de uma revisão bibliográfica de publicações científicas no período de 1980 a 2005, levantar conhecimentos produzidos sobre a ocorrência de gestações sucessivas na adolescência. Inicialmente, investigou-se a dinâmica reprodutiva da população adolescente e, em seguida, é apresentada a revisão de vários estudos que tratam das gravidezes recorrentes dessas jovens, procurando, inclusive, elencar os vários conceitos usados para especificar o fenômeno. Foi localizada pequena produção científica acerca do tema, contudo, nos trabalhos encontrados foram detectados dados importantes que concorrem para o entendimento do fenômeno, especialmente aqueles referentes ao seu número, à grande possibilidade de sua repetição na ausência de recursos protetores ao pós-parto, à escolaridade das jovens grávidas, ao seu retorno à escolarização e ao uso adequado que elas fazem de métodos anticoncepcionais. Entretanto, esses dados devem ser relativizados uma vez que vários autores descrevem altos índices de gestações recorrentes de adolescentes quando em parceria sexual fixa, quer sejam casadas ou em uniões consensuais. Nesse caso se pode pensar que essa população, após a primeira gravidez, definitivamente assume uma vida conjugal estável, modificando consideravelmente o perfil clássico da "adolescente grávida".
Chapter
Newborns are susceptible to injury caused by oxidative stress due to the immaturity of endogenous radical scavenging systems. However, premature exposure to supraphysiological oxygen levels in premature infants and widely used oxygen therapy in critically ill patients often cannot be avoided. Therefore, appropriate therapeutic strategies are highly warranted. This chapter will provide an overview on the known effects of oxygen in the critical phase of rapid brain development and its impact on perinatal brain injury.
Chapter
Effective biomedical informatics applications supporting newborn populations must go beyond simply adapting data systems or decision support tools designed for adult or even pediatric patient care. Within the neonatal intensive care unit (NICU), additional precision is required in the measurement of data elements such as age and weight where day-to-day changes may be clinically relevant. Data integration is also critical as vital information including the infant’s gestational age and maternal medical history originate from the mother’s medical chart or prenatal records. Access to these relevant data may be limited by barriers between institutions where care was provided, the transition between types of care providers (obstetrics to neonatology), appropriate privacy concerns, and the absence or unreliability of traditional identifiers used in linking records such as name and social security number. We explore challenges unique to the newborn population and review applications of biomedical informatics which have enhanced neonatal and perinatal care processes and enabled innovative research.
Article
Full-text available
Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, 97th percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26–42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice.
Article
One in three elders over the age of 65 falls each year in the United States. This paper describes a non-invasive fall detection system based on a Doppler radar sensor. The developed system has been tested in two environments: laboratory and real senior living apartments. While some laboratory results appeared in our previous papers, the main novelty of this paper consists in the deployment of our fall detection system in six apartments from TigerPlace (a senior living facility in Columbia, Missouri). The fall detection results obtained in our laboratory were excellent, with the radar placed on the ceiling performing better than on the floor. The fall detection system was then evaluated using radar data collected over two weeks in six TigerPlace apartments. The fall detection system successfully detected all six natural senior falls in an apartment for the examined one week.
Chapter
In most of the human societies we know about, both past and present, the male parent has been an important personage in the life of his children. Typically, he has lived with them and made substantial contributions toward the expense of raising them. Over the last half-century, we have been witnessing what appears to be a loosening of the economic and social bonds between men and their children. In the United States almost 20 million children—approaching 1 in 4 children—are being raised by mothers who do not have a husband living with them. Some of these husbandless mothers have another adult (who may or may not be the father of one or more of the children, and who may or may not be a sexual partner) as part of their household, but a large majority does not.
Article
The vast majority of pregnant women are subjected to electronic fetal heart monitoring during labor. There is limited evidence to support its benefit compared with intermittent auscultation. In addition, there is significant variability in interpretation and its false-positive rate is high. The latter may have contributed to the rise in operative deliveries. In order to address the critical need for better approaches to intrapartum monitoring, the MFMU Network has completed two large multisite randomized trials, one to evaluate fetal pulse oximetry and the other to evaluate fetal ECG ST segment analysis (STAN). Both of these technologies had been approved for clinical use in the United States based on prior smaller trials. These technologies were evaluated in laboring women near term and their primary outcomes were overall cesarean delivery for the oximetry trial and a composite adverse neonatal outcome for STAN. Both the trials failed to show a benefit of the technology, neither in the rates of operative deliveries nor in the rates of adverse neonatal outcomes. The experience with these trials, summarized in this report, highlights the need for rigorous evidence before introduction of new technology into clinical practice and provides a blueprint for future trials to address the need for better intrapartum monitoring approaches.
Article
Full-text available
Objective: The family arrangements of Latinos in the U.S. are increasingly diverse, with many living with their partners out of wedlock. Latinos also tend to be more religious than the population at large. Accordingly we examine the associations between religion and relationship quality among married and unmarried Latino couples. Methods: Data from the Fragile Families and Child Wellbeing Study, which focuses on parents in urban America, are used in conjunction with seemingly unrelated regression. Results: Church attendance generally promotes positive perceptions of union quality. Men's religious participation is more consequential than women's; married couples appear to benefit more from religion than do Latinos in cohabiting or visiting relationships. Finally, Latino men report worse relationships when their partners attend church regularly. Conclusion: Religion plays an important role in Latino families, although its effects are not uniformly positive.
Chapter
DefinitionsIncidenceEtiologyComplications of Post-Term PregnancyPrevention and Management of Post-Term PregnancyIntrapartum ManagementPrognosisConclusions Case PresentationReferences
Article
Full-text available
As the chromosomal examination of foetal cells for the prenatal diagnosis of Down’s syndrome (DS) carries a risk of inducing miscarriage, serum screening tests are commonly used before invasive procedures. In this study, a total of 374 records from PubMed, EMBASE, and the ISI Science Citation Index databases were reviewed. As a result of duplication, insufficient data, and inappropriate article types, 18 independent articles containing 183,998 samples were used in the final systematic review and meta-analysis of the diagnostic performance of the serum triple screening test (STS) and the integrated screening test (INS). Data extracted from the selected studies were statistically analysed, and the presence of heterogeneity and publication bias was assessed using specific software. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under the curve for the STS were 0.77 (95% confidence interval = 0.73–0.81), 0.94 (0.94–0.94), 9.78 (6.87–13.93), 0.26 (0.22–0.31), 44.72 (30.77–65.01), and 0.9064, respectively. For the INS, these values were 0.93 (0.90–0.95), 0.93 (0.93–0.93), 22.38 (12.47–40.14), 0.08 (0.05–0.11), 289.81 (169.08–496.76), and 0.9781, respectively. These results indicate that the INS exhibits better diagnostic value for DS. However, further research is needed to identify other biomarkers to improve prenatal screening tests.
Article
Full-text available
Macrosomia is defined as birthweight above a given value. The prevalence of large babies appears overall to have increased worldwide. The causes and risk factors for fetal macrosomia are diverse. Pregnancies with fetal macrosomia are high risk and require intensive antenatal care. Prediction of macrosomia is difficult, but prenatal ultrasound appears to be the most accurate method of estimation of fetal weight. The correct birthweight when using biometric formulae to determine the fetal weight is often underestimated. Management options when delivering a suspected macrosomic fetus include induction of labor, elective cesarean delivery and expectant management. Shoulder dystocia, postpartum haemorrhage and birthcanal injuries are more frequent. In modern Obstetrics the optimal management of suspected fetal macrosomia is a challenge and in our opinion the best way to manage fetal overgrowth is to prevent it.
Article
Full-text available
Introduction: Eclampsia continues to be a major cause of maternal and perinatal morbidity and mortality in the developing world. We evaluated the incidence and outcome of women diagnosed with eclampsia in a tertiary referral centre in eastern India. Methods:The prospective randomized study was carried out in the department of Obstetrics & Gynecology, MKCG Medical College and Hospital, Berhampur, Orissa, India, a tertiary level Government referral centre for whole of Southern Orissa, over a 2 year period. The incidence, demographics of women with eclampsia and response to three different regimens of magnesium sulphate was studied. Results: 160 women presented with convulsions against a background of preeclampsia of which 2 were diagnosed with cerebral malaria and hence excluded. Out of 4925 live births during the study period, there were 158 women with eclampsia, giving an incidence of 3.2%. Majority were unbooked 154 (97.4%) and from rural areas 133 (84.2%). Antepartum eclampsia occurred in 21(13.3%) patients; antepartum/intrapartum eclampsia in 108(68.3%) while postpartum eclampsia occurred in 29 patients (18.4%). Primigravidas accounted for 105/129 cases with antepartum & intrapartum eclampsia while primiparas accounted for 25/29 cases with postpartum eclampsia. The all cause maternal mortality in the study period was 67, of which a total of 7 women died due to eclampsia, giving a case fatality rate of 4.4% and maternal mortality ratio of 10.44%. Majority of the patients 75/158(47.45%) received magnesium sulphate at 4-8 hours after of onset of convulsions. 60 women received magnesium sulphate by Pritchard regimen (Group-A), while 49 each received magnesium sulphate by Zuspan regimen (Group-B) and Sibai regimen (Group-C). There was no recurrence of convulsions in any patient after start of magnesium sulphate in both Groups A and C, whereas there was recurrence of convulsion in 1 patient in Group-B. There were a total of 50 still births and 5 neonatal deaths out of total of 167 deliveries in the 158 women with eclampsia. The maternal mortality and morbidity did not differ significantly between the three groups; neither did the perinatal mortality and morbidity. Conclusion: Eclampsia continues to be a major cause of both maternal and perinatal morbidity and mortality. Magnesium sulphate was equally effective in controlling seizures in the three groups.
Article
Life-threatening anomalies can occur during the development of the embryo as a result of genetic and/or environmental factors. Some of these are now amenable to surgical intervention, and novel corrective procedures have increasing success rates. The fetus is highly dependent upon the placenta and its physico-chemical environment for growth and development. As the intrauterine environment exerts permanent alterations to organ development, it has the potential to have life-long consequences for health and disease.
Chapter
How far is the health of middle-aged and older women shaped by biological, social, and psychological processes that begin in pre-natal development, childhood, adolescence, or early adult life? Do health risks gradually accumulate over the life course or do experiences as a child and young adult have interactive effects on health in midlife and beyond? Are women now reaching middle age in better health than those from previous generations? This book reviews the latest scientific evidence on biological and social factors at each stage of life that have long-term effects on reproductive outcomes, breast cancer, cardiovascular disease, diabetes, musculoskeletal ageing, depression, body weight, and body dissatisfaction. There is growing evidence that the sources of risk to physical and mental health occur across the course of life, not just in adult life, and in some instances reach right back to pre-natal development, or the previous generation. Contributors in this book draw on their varied expertise in epidemiology, endocrinology, physiology, developmental psychology, sociology, and anthropology to identify the pathways that link early life experiences, reproductive events, adult lifestyle and lifetime socio-economic circumstances to later health. This book looks for connections between development and ageing, and between the childhood and adult social environment.
ResearchGate has not been able to resolve any references for this publication.